TNF and pulmonary edema: Therefore, Interleukin (IL)-6, IL-8 and tumor necrosis factor alpha (TNF-α) are increased in bronchial epithelial cells and alveolar macrophages and these cytokines can then activate macrophages and neutrophils, resulting in the destruction of the alveolar wall, the collapse of small airways, hyper-permeability of pulmonary capillaries and pulmonary edema, that result in the deterioration of pulmonary gas exchange [10].